Lift. Oomph. Thump. Lift. Oomph. Thump. Time and again, Gavin Class flips a 500-pound tractor tire around a Cockeysville fitness center. Next, he hoists a 20-pound medicine ball over his head and slams it to the ground 20 times. Finally, Class rams his shoulder into a conditioning sled weighing 165 pounds and drives it 30 yards. In a sprint.
Impressive feats, all — and more so considering that 15 months ago Class was unable to walk, talk or raise his arms even to brush his teeth. In August 2013, the Towson junior collapsed of heatstroke during a Tigers football practice. His body temperature soared to more than 108 degrees. His organs shut down. He lost consciousness. His heart stopped. His liver failed.
"It was like he'd been put in a microwave oven," said Dr. Stephen Bartlett, surgeon-in-chief at University of Maryland Medical Center, where Class, of Monkton, spent much of the next six weeks.
Twice, early on, his parents were told their son wasn't expected to last the night. Though a liver transplant saved his life, Class' recovery has proved a tumultuous ride marked by cancer, pancreatitis, a collapsed lung, pneumonia, shingles, appendicitis and enough infections to trigger 14 surgical procedures to date.
The ordeal lopped nearly 100 pounds off his 305-pound frame. At one point, while sitting in a chair beside his hospital bed, Class coughed. To his parents' horror, the entrails tumbled out of his loosely sewn abdomen and into his mother's hands. She held tight until help arrived.
And now? Class, 22, is back in school. He spent the fall working out in noncontact drills with the Tigers football team, in hopes of suiting up in 2015. The player who, before his injury, set a Towson record for offensive linemen by bench-pressing 440 pounds can now lift 345.
"It's a miracle that he pulled through this," said Dr. Mayur Narayan, a trauma surgeon at Maryland Shock Trauma who treated Class on his arrival. "This kid was the sickest person here. He had the highest temperature I'd ever seen and was knocking on death's door. Now he's working out with his team? These type injuries, where the body takes such insults, can take years for complete recovery. Gavin is way ahead of the curve."
In September, Class took part in a 5K at Camden Yards, the Donate Life Family Fun Run, a benefit that raises awareness for organ, eye and tissue donations. He finished in 26 minutes. Sunday, he ran the 5K at the Turkey Tumble for Autism at Patterson Park in 24 minutes.
"Doctors say I'm not 100 percent. I still have a little ways to go," Class said. "This was like a big speed bump in my life. I want to be able to say I was the first player to come back from heatstroke and a liver transplant to play football."
'A classic overachiever'
As a child, Class was willful and driven, those who know him said. At 12, he took part in a walkathon while nursing a broken ankle. Unable to limp all the way, he got hold of a wheelchair and finished the 3 miles. At St. Paul's, he refused to be sidelined by a thumb broken during lacrosse practice. Class had doctors mold a thumb cast around his lacrosse stick so he could play.
As an average-sized high school freshman, he determined to reinvent himself for football.
"Back then Gavin was, like, 5-11 and 160, not this stud who'd run over everyone," said Gordy Long, a St. Paul's classmate and longtime friend. Class employed a strength coach, lifted weights and beefed up. As a senior, he stood 6 feet 3 and weighed 260 pounds.
"He grew, literally, before our eyes," Long said. "He wanted to be the best he could be. And if a coach said he was too slow, he'd step up his training and use that critique to elevate his game."
At St. Paul's, Class captained the football team and was named its Most Valuable Player. Still, few colleges courted the two-way lineman who landed at Rochester, a Division III school. After two years he sought a change and, in 2012, transferred to Division-I Towson, where his single-mindedness struck the staff.
"The guy kept challenging himself and climbing the ladder," Tigers coach Rob Ambrose said. "Here was a barely recruited kid out of high school who went to a small college and realized, 'I'm better than this.'
"Gavin may have been a half-step slow when he got here, and not as strong or as quick as the others, but he wouldn't let that beat him. He had a tank in him and he wouldn't quit. He's a classic overachiever, and you've got to love that."
Having redshirted in 2012, Class kept plugging, gained 30 more pounds and, in 2013, started at right guard in the Tigers' intrasquad scrimmage Aug. 10.
"He kicked butt," Jonathan Class said of his son's play that day. "Gavin was totally focused and in the best shape of his life. Towson was a perfect fit for him. He said, 'It's everything I ever wanted.'"
Two days later, tragedy struck.
As he ran 10-yard sprints with other linemen near the end of practice at Johnny Unitas Stadium, Class began to labor. It was 90 degrees and cloudy around 5 p.m. as the Tigers wrapped up the second of two workouts.
"Gavin had been training well that day," offensive line coach John Donatelli recalled. "He was the role model for hard work. Every rep was so important to him; he faced each one like it was his last."
Class' struggles caught the eye of Towson's head athletic trainer, Nathan Wilder.
"You could see he was fatigued, but he never let on that he had a problem," Wilder said. "It wasn't until the last sprint that Gavin became completely uncoordinated. He looked like a puppet, with strings attached, and he fell to his knees."
Wilder and Donatelli hurried out to help.
"Let me finish," Class gasped, speech slurred and fighting to rise as they tore off his helmet.
"You're done," Donatelli told him. With that, Class slumped to the ground, his eyes rolled back in his head and the trainer called 911.
'Keep fighting ... don't give up!'
Four trainers carried Class several yards and plunged him into a cold tub, one of four 300-gallon containers filled with ice water that are always on hand.
"He was hyperventilating and struggling to maintain consciousness," Donatelli said. "I jumped in the tub, straddled him and splashed water in his face so he'd open his eyes. I shouted, 'C'mon Gavin, you're not going anywhere, stay with me, stay with me, I'm here, Coach D. I love you man.'"
Ten minutes later, paramedics arrived and hurried Class by ambulance to St. Joseph Medical Center, less than a half mile away. Doctors now say that cooling Class in the 50-degree water probably saved his life.
"If his temperature was 108 after being in the cold tub, you can bet it was a couple of degrees higher before that," Narayan said.
Arriving at the hospital, Jonathan Class spotted about 25 Towson players standing outside, crying.
"The first thing the emergency room doctor told us was, 'Your son is really sick and will probably die,'" he said. "Gavin was in a coma, packed in ice from head to foot and hooked up to every machine imaginable. We told him we loved him and, for a precious two minutes, grasped his left hand."
Overnight, Class' condition improved. His temperature fell and his kidneys, which had shut down, kicked in. But when his liver began to fail — a perilous sign — Class was rushed to Maryland Shock Trauma Center. There, he went into cardiac arrest and his kidneys failed again. For the second time in 24 hours, doctors told his family to brace for the worst.
"Gavin was in a deep, deep coma and near death," Bartlett, the surgeon, said. "Everything had shut down and he was eating up his own muscles. As sick as he was, his liver was releasing toxins into his body and making things much, much worse."
At his bedside, Danielle Class screamed at the comatose form of her only child:
"Keep fighting, keep fighting, you're strong, don't give up!"
Class was wheeled to the Critical Care Resuscitation Unit and placed on both kidney and liver dialysis. Three weeks earlier, Shock Trauma had opened the CCRU as an emergency room for intensive care patients. At the same time, the facility had purchased a liver dialysis machine, the first in the Mid-Atlantic. Class was the first patient to use the device as a bridge to transplant.
A healthy liver was key to his survival, said Dr. Rolf Barth, director of liver transplantation at UMMC. And Class' own organ had all but succumbed to the ravages of heatstroke.
"Your liver can regenerate, but 95 percent of Gavin's had died," Barth said. "We knew if we could get him through the liver component of all this, his other organs could recover."
Even with a transplant, however, Class' odds were one in four. So a team of surgeons and psychologists huddled, much as NFL teams do on draft day, to decide whether Class had the spunk to fight on. The vote was unanimous.
"We don't pick wimps," Barth said.
With time running out, the hospital placed Class near the top of the national transplant waiting list of 16,000. Within a day, it had a match — a 51-year-old organ donor from Pittsburgh with the same A-positive blood type.
At UMMC, friends and teammates gathered to pray. Long tiptoed into Class' room and gingerly placed his Towson jersey (No. 66) on his chest.
"I was scared even to breathe, but I cherished that moment," Long said.
Meanwhile, a surgical team of nearly 20 readied for what would be a grueling six-hour procedure. Beforehand, they gathered around the patient where his mother addressed them.
"God gave you a gift," she told them. "Now use your gift to save my son."
Barth, who performed the operation, likened it to football.
"It was our big game," he said. "We planned things like coaches putting X's and O's on a blackboard. We looked at images, made plans, wore uniforms and said a prayer. There are lots of moving parts to be coordinated during surgery. It was tough physically. We don't always win, but we win a lot more than we lose."
Class' size complicated things.
"He's one of the largest people we've ever transplanted. Operating on such a massive and muscular young man is challenging," Barth said. "Removing a big, tough diseased liver — his was pale, ghostlike and weighed more than 3 pounds — and putting in a new one takes a lot of finesse; we wore magnifying binoculars on our glasses. Even though he was asleep, we felt like we were 'working out' against Gavin."
'This isn't a normal human being'
The scar resembles a Mercedes logo, an inverted V that starts below the sternum and fans out to either side. Surgeons used 47 staples to seal the incision. Months later, Class had reference to a Bible verse — Philippians 4:13 — tattooed on his chest: "I can do all things through Christ who strengthens me."
A tattoo? Why stress the flesh again?
"I wanted something to embrace everything that happened, and that verse stuck with me," Class said. "Anyway, I'm used to needles now."
He has no memory of his collapse and little of the next few weeks, when he fought off the aftershocks of the trauma, everything from pneumonia to lymphoma. Four weeks of chemotherapy left Class cancer-free.
"It's like I went to sleep in August and woke up in October," he said.
With friends and teammates rooting him on.
"Gavin's jersey hung by our locker room door," said Peter Athens, then Towson's quarterback. "Every day, as we went outside, each guy would tap his number."
Beneath their own jerseys, the Tigers wore T-shirts bearing Class' number and the Superman emblem.
By his own measure, Class' recovery has been agonizingly slow. He had to relearn basic skills from scratch.
"At first, I could hardly stand up for 10 seconds," he said. "When I finally got home, my big goal was to walk down the driveway to the mailbox."
His comeback inspired those around him.
"When I first saw him in the hospital he could barely squeeze hand putty," said Jay Dyer, a strength and conditioning specialist in Cockeysville who monitored his therapy. "Gavin has fought his way back from the most extreme circumstances."
His will won out, friends said.
"This isn't a normal human being that we're talking about," Long said. "I kept hearing that he might not be able to run or walk or even eat by himself. Now he's doing all of those things faster than me."
Class returned to school in January. He attended the Tigers' Football Championship Subdivision title game Jan. 5 in Frisco, Texas, and addressed the team in a heartfelt speech the night before.
"He told them that he'd died, for a while, but that God had brought him back to be a part of our year," Ambrose said. "There wasn't a dry eye in the room"
Though Towson lost that game, 35-7 to North Dakota State, it was clear that Class had an impact on a historic season.
"Gavin's incident helped bring this team together," Donatelli said. "Unfortunately, tragedy galvanizes unity; the most important thing to us is us."
'He'll listen to his heart'
Over the past 20 years, 54 football players in the United States have died from heatstroke (42 high school, nine college, two pro and one sandlot), according to the National Center for Catastrophic Sport Injury Research.
Two confirmed deaths in 2014 include Marquese Meadow, an 18-year-old freshman at Morgan State who fell ill during a team workout Aug. 10. Meadow, a 300-pound lineman from Washington, died two weeks later of complications from heatstroke at The Johns Hopkins Hospital.
Meadow's death is one of two at the college level since 2003, when the NCAA embraced heat acclimitization guidelines.
"The numbers are trending down, which correlates with the safety policies that have been put in place, but remember these are small numbers. You can't take them year by year," said Kristen Kucera, director of the NCCSIR.
Class' setback brought changes to Towson's training regimen.
"We have periods of rest now, so it's not go-go-go," said Wilder, the trainer. "While running sprints, players remove their helmets to let the heat escape. After practice, it's mandatory for them to sit in the cold tubs for seven to 10 minutes. Also, we've added a slushie machine since studies show that frozen beverages bring one's core temperature down fast."
Players bear some responsibility for their own well-being, he said.
"When a kid feels uncomfortable, he has to speak up. The days of being macho and going without water are gone," Wilder said. "You've got to be intelligent out there."
Class' parents said they don't blame the university for their son's ills and that they embrace the reforms that have been made.
"Towson has lived up to its promises," Jonathan Class said. "It has walked the walk."
His son shrugs off the past year.
"It's just something that happened," he said. "God has a plan, and this was in my path, and he kept me alive for a greater purpose."
On Aug. 14, one year after his transplant, Class' family and friends met at a local restaurant for celebration. They called it Gavin's "Liverversary."
Now 245 pounds, he hopes to gain 40 by next fall, should doctors permit him to suit up.
"If I'm to play, I need protection [for the abdomen], maybe something Kevlar-related," Class said.
Doctors at UMMC are guarded on his football future. Class would be, they said, the first liver transplant patient ever to compete in a contact sport.
"We want Gavin to live a long and productive life but, like an overprotective mother, we're also kind of partial to his liver," Barth said. "Still, with the right kind of padding, there's no reason to think he couldn't play again."
But should he?
"If I were him, I think sitting in the stands would be a good place to be," Narayan said. "But he'll listen to his heart. What drives him now is also what helped him get through this."